Annals of Hematology

, Volume 89, Issue 8, pp 783–787 | Cite as

Concomitant statin use does not impair the clinical outcome of patients with diffuse large B cell lymphoma treated with rituximab-CHOP

  • Panagiotis Samaras
  • Helen Heider
  • Sarah R. Haile
  • Ulf Petrausch
  • Niklaus G. Schaefer
  • Raffaele Daniele Siciliano
  • Alexander Meisel
  • Axel Mischo
  • Martin Zweifel
  • Alexander Knuth
  • Frank Stenner-Liewen
  • Christoph Renner
Original Article


Preclinical data indicated a detrimental effect of statins on the anti-lymphoma activity of rituximab. We evaluated the impact of concomitant statin medication on the response and survival of patients with diffuse large B cell lymphoma (DLBCL) receiving rituximab–cyclophosphamide, doxorubicin, vincristine, prednisone (R-CHOP) as first-line therapy. Medical histories of patients with DLBCL who were treated with R-CHOP as first-line therapy were assessed for concomitant statin use, response after completion of chemotherapy, event-free survival (EFS), and overall survival (OS). Furthermore, 2-[18F]fluor-2-deoxyglucose (FDG)-PET/CT results after completion of first-line therapy were compared between the groups. Overall, 145 patients with DLBCL treated with R-CHOP from January 2001 to December 2009 were analyzed. Twenty-one (15%) patients received statins throughout therapy. Five-year EFS was 67.3% in patients without statins compared with 79% in patients receiving statins during R-CHOP (HR, 0.47; 95% CI, 0.15–1.54, p = 0.2). Five-year OS was 81.4% for patients without statins compared with 93.3% for patients taking statins (HR, 0.58; 95% CI 0.07–4.55, p = 0.6). There were no statistically significant differences in the rates of complete remissions between the two groups (75% in the non-statin group versus 86% in the statin group, p = 0.45). A trend toward a lower rate of complete metabolic responses in FDG-PET/CT after chemotherapy was seen in patients without statin medication compared with the patients taking statins (84% versus 92%, p = 0.068). Concomitant statin use had no adverse impact on response to chemotherapy, EFS, and OS in patients treated with R-CHOP for DLBCL.


Statins Diffuse large B cell lymphoma Rituximab R-CHOP Survival 



Diffuse large B cell lymphoma


Rituximab–cyclophosphamide, doxorubicin, vincristine, prednisone


Event-free survival


Overall survival


2-[18F]fluor-2-deoxyglucose–positron emissions tomography


Computed tomography


Cluster of differentiation 20


International prognostic index


Hazard ratio


Confidence interval


Complete remission


Unconfirmed complete remission


Partial remission


Stable disease


Progressive disease


Human immunodeficiency virus


3-Hydroxy-3-methylgutaryl coenzyme A reductase


Complement-dependent cytotoxicity


Antibody-dependent cellular cytotoxicity


Monoclonal antibody


Authorship and disclosures

PS, HH, FS-L, and CR designed the study, collected, and analyzed the data and wrote the manuscript. SRH performed the statistical analysis, NGS performed the imaging analysis. RDS, UP, AM, AM, MZ, and AK participated in the patients’ care and the data analysis.

All authors were involved in the revision process and approved the final manuscript. No conflicts of interest are present.


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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Panagiotis Samaras
    • 1
  • Helen Heider
    • 1
  • Sarah R. Haile
    • 2
  • Ulf Petrausch
    • 1
  • Niklaus G. Schaefer
    • 1
    • 4
  • Raffaele Daniele Siciliano
    • 3
  • Alexander Meisel
    • 1
  • Axel Mischo
    • 1
  • Martin Zweifel
    • 1
  • Alexander Knuth
    • 1
  • Frank Stenner-Liewen
    • 1
  • Christoph Renner
    • 1
  1. 1.Department of OncologyUniversity Hospital ZürichZürichSwitzerland
  2. 2.Biostatistics Unit, Institute of Social and Preventive MedicineUniversity of ZurichZurichSwitzerland
  3. 3.Medical Oncology, Triemli City HospitalZurichSwitzerland
  4. 4.Division of Nuclear Medicine, Department of Medical RadiologyUniversity Hospital ZurichZurichSwitzerland

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